METHODS: A 40-year-old male with alcohol dependence (for 20 years) reported new-onset terrifying nightmares and violent behaviours in his sleep precipitated by alcohol withdrawal states for the last 18 months. The polysomnographic finding of REM-without-atonia supported the diagnosis of RBD. He was treated with chlordiazepoxide 100 mg/day (gradually tapered and stopped) and thiamine supplements. Post-discharge, he remained abstinent and symptom-free during the three months of follow-up.
CONCLUSIONS: RBD related to alcohol withdrawal syndrome has been previously described in a few anecdotal reports. Sudden withdrawal from central nervous system suppressants like alcohol is hypothesised to cause a homeostatic imbalance in gamma-aminobutyric acid (GABA) pathways and \'REM rebound\', resulting in the clinical and polysomnographic picture of RBD. Benzodiazepines have been found to be useful in both RBD and alcohol withdrawal.
CONCLUSIONS: Alcohol withdrawal syndrome may present with acute RBD, which can be treated with a short course of benzodiazepine. However, further studies are needed to explore the long-term course of RBD in these patients.
方法:一名患有酒精依赖的40岁男性(长达20年)报告说,在过去的18个月中,他的睡眠中出现了新的可怕噩梦和暴力行为,这些行为是由酒精戒断状态引起的。无张力的REM多导睡眠图发现支持RBD的诊断。他用氯二氮卓100毫克/天(逐渐减量并停止)和硫胺素补充剂治疗。放电后,在3个月的随访期间,他保持戒断和无症状.
结论:与酒精戒断综合征相关的RBD先前已在一些轶事报告中描述过。假设突然从中枢神经系统抑制剂如酒精中撤出会导致γ-氨基丁酸(GABA)途径和“REM反弹”的稳态失衡,导致RBD的临床和多导睡眠图。已经发现苯二氮卓类药物在RBD和酒精戒断中都是有用的。
结论:酒精戒断综合征可能表现为急性RBD,可以用短程苯二氮卓类药物治疗。然而,需要进一步的研究来探讨这些患者RBD的长期病程.